This K24 application has two broad goals: mentoring junior investigators in patient-oriented research and pursuing and expanding a research program in the genetics and prevention of gastrointestinal cancers. The candidate, Sapna Syngal, MD, MPH, is an Assistant Professor of Medicine at Harvard Medical School, with dual appointments in the Population Sciences Division of Dana-Farber Cancer Institute and the Gastroenterology Division at Brigham and Women's Hospital. She has established a track record at supporting and advancing the careers of physicians pursuing patient-oriented research in gastroenterology. Her current group of mentees include 14 post-doctoral fellows, all who are physicians from a variety of subspecialty backgrounds including gastroenterology, genetics, internal medicine and oncology. All mentees who have completed training with Dr. Syngal obtained a Masters in Public Health from the Harvard School of Public Health during their training period and currently hold faculty positions in academic institutions, devoting the majority of their time to pursuing patient-oriented research. Dr. Syngal is an active faculty member of a variety of NIH training grants, including a T32 in Gastroenterology, a T32 in Genetics and a R25 in Cancer Outcomes - these training grants provide salary support for the current post-doctoral fellows in Dr. Syngal's program as well as tuition costs for the MPH degree. She has been honored for mentoring by the Dana-Farber Cancer Institute Fred P Li Award for Mentoring in 2003. Dr. Syngal's research program includes evaluation of (1) screening compliance in patients at high risk for colorectal cancer;(2) the role of the mismatch repair gene, MSH6 in familial colorectal cancer;(3) the impact of genetic testing on surveillance and management of hereditary colon cancer;(4) the development of a prediction rule for mutation carriers in the MSH2 and MLH1 genes;and (5) the study of stool DMA tests and other biomarkers for early detection of colorectal cancer. Dr, Syngal is the Principal Investigator of a K07 and an RO1 award and a co-investigator on several other multi-center NIH grants. Dr. Syngal received the Young Investigator Clinical Science Award in 2004 by the American Gastroenterological Association, the, highest honor given by the AGA to one junior faculty clinical investigator nationally per year.